No coin nor oath required. For personal study only.
Aims: Spontaneous cerebral emboli (SCE) are associated with memory loss in carotid and cardiac surgery. We examined the frequency of SCE and carotid disease in patients with Alzheimer's disease (AD) and vascular dementia (VaD). Methods: A total of 150 patients (AD = 74, VaD = 76) with dementia and 150 age-and sex-matched controls from the same GP list were recruited. SCE were counted by continuous transcranial Doppler over 1 hour of both middle cerebral arteries. The criteria for SCE were from the International Consensus Committee (1995). Results: SCE were detected in 28/74 (38%) AD patients and in 28/76 (37%) VaD patients in a single hour compared with 10/74 (13•5%) and 10/76 (13%), respectively, for their controls. The odds ratio (OR) (95% CI) for AD patients was 3•0 (1•4-6•4, P = 0•004) and for VaD was 5•5 (1•9-16•0, P = 0•002). Moderate to severe carotid disease (≥ 50% stenosis) was present in 7/76 (9%) of AD patients and 18/71 (18%) of VaD patients compared with 12/76 (16%, P = 0•21) and 20/71 (27%, P = 0•67) of their respective controls. AD and VaD were both associated with cardiovascular risk factors but VaD patients were more likely to have a history of stroke [22% vs. 4% in controls,, P = 0•006] or transient ischaemic attacks [60% vs. 9% in controls, OR 20•5 (5•0-84•8), P < 0•001]. Conclusions: AD and VaD may have the same cause as SCE were common in both disorders compared to 'healthy' controls. SCE may be a preventable or treatable cause of dementia.
📜 SIMILAR VOLUMES